Psychology and mental health

Depressive episodes and dysphoria resulting from conjugal bereavement in a prospective community sample

Article Abstract:

Depression as a result of the loss of a spouse has been well documented, and is considered to be a normal expression of grief. However, there are no methods for clearly differentiating depressive episodes that are a normal part of the grieving process from more serious major depressive episodes in individuals who have recently lost a spouse. The variation in grief reactions was examined by evaluating three interviews that were conducted as a part of the New Haven Epidemiologic Catchment Area sample. During the course of the study, 39 individuals out of 1,180 participants were widowed. All of the subjects were over 45 years old and were equally as likely to have had a previous episode of dysphoria at the time they first entered the study. The findings were similar to those of previous studies, which have reported high rates of depressive symptoms among individuals who are newly bereaved. Both depressive episodes and dysphoria (feelings of anxiety, restlessness, and depression) were more common in the bereaved group than in the married group. Of the 39 individuals who had lost a spouse, almost two thirds reported having periods of dysphoria that lasted for two weeks or more. Nearly one third of this group met the Diagnostic and Statistical Manual of Mental Disorders, third edition (DSM-III), criteria for a major depressive episode. No significant differences were found that related to sex, age, and household size among the depressed. However, those who were bereaved lacked feelings of guilt or worthlessness compared with the married depressed subjects. No suicide attempts were reported, and none of the bereaved subjects reported suicidal thoughts, but the majority did report a preoccupation with death. It was concluded that a significant number of newly widowed individuals have symptoms of major depression as defined in the DSM-III. More information is needed on the long- and short-term effects of the serious episodes which accompany or may be a part of the grieving process. Those having prolonged depressive symptoms should be carefully monitored and assessed for further complications or additional disorders. (Consumer Summary produced by Reliance Medical Information, Inc.)

Exploring the multidimensional aspects of grief reactions

Article Abstract:

Psychiatrists have studied grief reactions for many years but have encountered difficulty in defining and measuring the signs and symptoms of grief. Two hundred and one intimate friends and close relatives of persons who had recently died a violent death or sudden natural death were interviewed about their feelings during early bereavement. Those who died violently were victims of suicide, homicide or accidental death. Those who died of natural causes died unexpectedly, without prolonged illness, and were no older than 70 years. It should be noted that the respondents were recruited from the general population and were not psychiatric patients. Depression was a very prominent aspect of grief, reported by 99 percent of the respondents, and suicidal thoughts were noted in 56 percent of those interviewed. These feelings were considered part of a phase in which the grieving yearn and search for the deceased person. Another aspect of grief was symbolic preservation of the lost loved one; this took the form of erecting an altar to honor the deceased and pretending the lost spouse was still there at meals and in bed at night. Many respondents (43 percent) felt angry at the person who died, and experts believe this may be helpful or even necessary for accepting the loss. In conclusion, the grief reactions had many dimensions. Certain forms of grief which have been classified previously as pathological (abnormal) were observed in many subjects from the general population. This suggests that the abnormality of a reaction should be judged by its frequency and intensity, rather than simply by its existence.

Sequelae of bereavement resulting from suicide

Article Abstract:

It has often been asked whether bereavement resulting from suicide differs from bereavement due to other types of death. More than 30,000 suicides occurred in the U.S. during 1988, with over a quarter of these by persons 24 years old or younger. These deaths left many surviving family members and friends behind. Clinical reports suggest that the survivors are at increased risk for experiencing extreme grief and other adverse effects. Also, the nature of the death seems to affect the resulting psychology of the grieving process. This study was done to identify differences in the grieving process, social and psychological adjustments, family backgrounds, mortality rates and risk of own suicide, and attitudes of others toward those bereaved by suicide. Differences in the grieving processes were found, including the content of the preoccupations of the bereaved after a suicide. After the initial shock there is a process of searching for the reason, which often remains incomprehensible. Suicide of a family member may be a risk factor for suicide among the bereaved. It was noted that persons bereaved by suicide were socially set apart from other bereaved persons, usually by attitudes of blame. It has been observed that members of "suicide survivors" support groups feel a deep sense of relief after telling their stories, but such groups might not be effective for everybody. (Consumer Summary produced by Reliance Medical Information, Inc.)